Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report
Introduction. After the contact with a patient suffering from tuberculosis (TB), previously healthy children have 1%–16% possibility to develop the disease. TB diagnosis in children is not easy to confirm so 15%–25% of cases remain undiagnosed. Case report. A 15-yearold- boy was hospitalized with pr...
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| Format: | Article |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2018-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600282K.pdf |
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| author | Kostić Gordana Medović Raša Marković Slavica Rašković Zorica Igrutinović Zoran Ćupurdija Vojislav Petrović Marina |
| author_facet | Kostić Gordana Medović Raša Marković Slavica Rašković Zorica Igrutinović Zoran Ćupurdija Vojislav Petrović Marina |
| author_sort | Kostić Gordana |
| collection | DOAJ |
| description | Introduction. After the contact with a patient suffering from tuberculosis (TB), previously healthy children have 1%–16% possibility to develop the disease. TB diagnosis in children is not easy to confirm so 15%–25% of cases remain undiagnosed. Case report. A 15-yearold- boy was hospitalized with productive cough, pain in the right flank area, fever, and fatigue, loss of appetite and night sweats. One of the boy's uncles was cured of tuberculosis, another uncle had active tuberculosis and both of them were in contact with the boy, but they did not live in the same household. During the physical examination, the child was febrile, with dyspnea, pale, with profuse sweating, debilitate. BCG (Bacillus Calmette – Guérin) scar was present. The auscultatory findings of the lungs showed quiet breathing from the scapula to the right lung base and chest radiography suggested massive right sided pleuropneumonia. The parameters of the inflammation were high and Mycobacterium tuberculosis (MTB) was not found in the samples of sputum and gastric lavage. Pleural puncture revealed exudative nature in the aspirated fragment. Cytology was nonspecific, the MTB was not found and the planted surfaces on Lowenstein-Jensen remained sterile. Tuberculin skin test (TST) – Mantoux was positive (+ 10 mm), Interferon Gamma Release Assay (QuantiFERON- TB GOLD In-Tube) was negative. The boy was unsuccessfully treated with broad spectrum antibiotics. By video-assisted thoracoscopy, the pleural tissue clip confirmed the benign chronic granulomatous process, while histochemical staining did not show MTB. The treatment with anti-TB medication led to clinical and radiographic recovery. The boy is now in good general condition, without consequences of the disease. Conclusion. This case report pointed out the importance of risk factors and difficulties in diagnosing TB in children. |
| format | Article |
| id | doaj-art-036477d9bdce4a0db547e55d63cf4460 |
| institution | DOAJ |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-036477d9bdce4a0db547e55d63cf44602025-08-20T03:16:45ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202018-01-0175551652010.2298/VSP160322282K0042-84501600282KDifficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case reportKostić Gordana0Medović Raša1Marković Slavica2Rašković Zorica3Igrutinović Zoran4Ćupurdija Vojislav5Petrović Marina6Clinical Center Kragujevac, Clinic for Pediatrics, Kragujevac + Faculty of Medical Sciences, KragujevacClinical Center Kragujevac, Clinic for Pediatrics, Kragujevac + Faculty of Medical Sciences, KragujevacClinical Center Kragujevac, Clinic for Pediatrics, Kragujevac + Faculty of Medical Sciences, KragujevacClinical Center Kragujevac, Clinic for Pediatrics, Kragujevac + Faculty of Medical Sciences, KragujevacClinical Center Kragujevac, Clinic for Pediatrics, Kragujevac + Faculty of Medical Sciences, KragujevacFaculty of Medical Sciences, Kragujevac + Clinical Center Kragujevac, Center for Pulmonary Diseases, KragujevacFaculty of Medical Sciences, Kragujevac + Clinical Center Kragujevac, Center for Pulmonary Diseases, KragujevacIntroduction. After the contact with a patient suffering from tuberculosis (TB), previously healthy children have 1%–16% possibility to develop the disease. TB diagnosis in children is not easy to confirm so 15%–25% of cases remain undiagnosed. Case report. A 15-yearold- boy was hospitalized with productive cough, pain in the right flank area, fever, and fatigue, loss of appetite and night sweats. One of the boy's uncles was cured of tuberculosis, another uncle had active tuberculosis and both of them were in contact with the boy, but they did not live in the same household. During the physical examination, the child was febrile, with dyspnea, pale, with profuse sweating, debilitate. BCG (Bacillus Calmette – Guérin) scar was present. The auscultatory findings of the lungs showed quiet breathing from the scapula to the right lung base and chest radiography suggested massive right sided pleuropneumonia. The parameters of the inflammation were high and Mycobacterium tuberculosis (MTB) was not found in the samples of sputum and gastric lavage. Pleural puncture revealed exudative nature in the aspirated fragment. Cytology was nonspecific, the MTB was not found and the planted surfaces on Lowenstein-Jensen remained sterile. Tuberculin skin test (TST) – Mantoux was positive (+ 10 mm), Interferon Gamma Release Assay (QuantiFERON- TB GOLD In-Tube) was negative. The boy was unsuccessfully treated with broad spectrum antibiotics. By video-assisted thoracoscopy, the pleural tissue clip confirmed the benign chronic granulomatous process, while histochemical staining did not show MTB. The treatment with anti-TB medication led to clinical and radiographic recovery. The boy is now in good general condition, without consequences of the disease. Conclusion. This case report pointed out the importance of risk factors and difficulties in diagnosing TB in children.http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600282K.pdftuberculosispleural effusionchilddiagnosisrisk factorIFN-gamma release assay |
| spellingShingle | Kostić Gordana Medović Raša Marković Slavica Rašković Zorica Igrutinović Zoran Ćupurdija Vojislav Petrović Marina Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report Vojnosanitetski Pregled tuberculosis pleural effusion child diagnosis risk factor IFN-gamma release assay |
| title | Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report |
| title_full | Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report |
| title_fullStr | Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report |
| title_full_unstemmed | Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report |
| title_short | Difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15-year-old boy from contact with a patient with tuberculosis: A case report |
| title_sort | difficulties in diagnosis of tuberculosis without bacteriologic confirmation in a 15 year old boy from contact with a patient with tuberculosis a case report |
| topic | tuberculosis pleural effusion child diagnosis risk factor IFN-gamma release assay |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2018/0042-84501600282K.pdf |
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